Male Death Registration: Year: 1971 number: 2905
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 002905
1. PLACE OF DEATH County of Halifax If in City or Town Eastern Passage
If death occured in a hospital or institution Ocean View Manor
3. PRINT NAME OF DECEASED Keizer, Russell Stanford
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
German
7. Single, Married
widowed
8. BIRTHPLACE Port Bickerton
9. DATE OF BIRTH 6 24, 1879
10. AGE in Years91 Months9 Days15 | hrs or mins
11. Trade or profession Fisherman
12. Kind of industry
13. Date last worked 1959 14. Total years
15. If married name of spouse
16. NAME of Father Isiah Keizer
17. BIRTHPLACE Port Bickerton, NS
18. NAME of Mother Annie Hallett
19. BIRTHPLACE Port Bickerton, NS
20. Signature of Informant Victor Keizer
address 5545 Atlantic St., Halifax, NS
Relationship to deceased Grandson
21. Place of burial Necum Teuch, NS
Date of burial April 10, 1971
22. Undertaker Veinotte & Sons Funeral Service Ltd.
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH April 8, 1971
CAUSE OF DEATH
(a) Arteriosclerosis
(b) Pneumonia
(c)
other Cardiac Failure
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=494982
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